# Decitabine + cedazuridine (oral)

Source: https://onco.cc/drugs/decitabine-cedazuridine/  
OnCo record `decitabine-cedazuridine` (Treatment). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Oral decitabine-cedazuridine is a pill version of the hypomethylating chemotherapy that, since May 2026, lets older AML patients take their whole venetoclax regimen at home.

## Summary

Cedazuridine inhibits cytidine deaminase in the gut and liver so oral decitabine achieves IV-equivalent exposure. Approved for MDS/CMML (2020). On 13 May 2026 the FDA approved Inqovi with venetoclax for newly diagnosed AML in adults ≥75 or with comorbidities precluding intensive induction, based on ASCERTAIN-V (CR 41.6%, median time to CR 2 months), the first all-oral hypomethylating regimen for AML.

## Fields

- Kind: Treatment
- Status: approved
- Last checked: 2026-09-07
- Also known as: Decitabine-cedazuridine; Oral decitabine; Cedazuridine
- Brand: Inqovi
- Modality: Oral hypomethylating agent
- Mechanism: Decitabine incorporates into DNA and traps DNMT1; cedazuridine protects it from first-pass deamination.
- Approvals: US 2020: MDS and CMML; US 2026: Newly diagnosed AML, unfit for intensive induction, with venetoclax (ASCERTAIN-V); EU 2023: EU brand Inaqovi
- Dosing: Oral; One tablet (35 mg decitabine / 100 mg cedazuridine) daily on days 1-5 of each 28-day cycle, with venetoclax 400 mg daily after ramp-up

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Decitabine/cedazuridine
- FDA label (DailyMed): https://dailymed.nlm.nih.gov/dailymed/search.cfm?query=Decitabine

## Connected records

- cancers: [Acute myeloid leukaemia](https://onco.cc/cancers/aml/), [Chronic myelomonocytic leukaemia and MDS/MPN overlap neoplasms](https://onco.cc/cancers/cmml/), [Higher-risk myelodysplastic syndromes](https://onco.cc/cancers/mds-higher-risk/), [Myelodysplastic syndromes / neoplasms (MDS)](https://onco.cc/cancers/mds/)
- technologies: [Epigenetic drugs (HDAC, DNMT, EZH2, IDH, menin, BET)](https://onco.cc/technologies/epigenetic-drugs/)
- drugs: [Decitabine](https://onco.cc/drugs/decitabine/), [Venetoclax](https://onco.cc/drugs/venetoclax/)
- companies: [Taiho Oncology (Otsuka)](https://onco.cc/companies/taiho-oncology/)
- trials: [ASCERTAIN-V](https://onco.cc/trials/ascertain-v/)
- pairings: [Venetoclax + hypomethylating agent](https://onco.cc/pairings/venetoclax-plus-hma/)
- ideas: [Shorter venetoclax courses in unfit AML](https://onco.cc/ideas/idea-shortened-venetoclax/), [Unmask hidden antigens with a short epigenetic course before immunotherapy](https://onco.cc/ideas/idea-bio2-epigenetic-priming-cold-tumours/)
- roadmaps: [Epigenetic therapy roadmap: loosening silenced genes → mutation-specific enzymes → editing the epigenome](https://onco.cc/roadmaps/epigenetics-roadmap/)
- terms: [Epigenetic progenitor theory: cancer without a first mutation](https://onco.cc/terms/epigenetic-progenitor-theory/)

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